Prisma Health
Managed Care Contract Analyst, Corporate Greenville, FT, Day - Re...
Prisma Health - Greenville, South Carolina, us, 29610
Work at Prisma Health
Overview
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Overview
Inspire health. Serve with compassion. Be the difference.
Job Summary
Coordinate system-wide hospital and physician services contracting, including but not limited to, strategy formulation, contract terms and contract performance. Coordinate the implementation, presentation and servicing of all contracts for the entire system. Provides system wide managed care education and communication.
Remote work can be considered for this position. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference
Perform contract language review, negotiate and recommend language and reimbursement changes/terms/provisions with payors in accordance with Prisma Health best practices independently as well as in collaboration with Manager, Managed Care Contracting, Financial Project Analysts and Director of Payor Contracting.
Coordinate and assists in managing the processing of all payer contracts and amendments within specified time frames or deadlines in collaboration with internal departments with minimal supervision. Manages and processes payer contracts and amendments including language and reimbursement review. Implements contracts and amendments with team members and internal departments. Tracks and monitors in database, contracts, amendments and renewals.
Provide problem solving support to Prisma Health affiliates and departments. Work closely with payers to ensure that Prisma Health receives all provider manual changes, provider bulletins, benefit plan changes and other payer documents. This position distributes this information throughout Prisma Health in a timely fashion. Conduct pro-active communication, contract compliance, and educational sessions. Develop and maintain effective relationships with payers and internal customers.
Perform detailed analyses of the financial and operational impact of procedural changes implemented by payers in collaboration with financial analysts.
Develops and maintain contracting decision making and tracking tools.
Participate and collaborate on special projects as assigned by Director, of Contracting or Vice President.
Performs other duties as assigned.
Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements Education - Bachelor's degree in Business or a related field.
Experience - Three (3) years of managed-care experience. Experience in a contracting or provider relations role preferred.
In Lieu Of In Lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: high school diploma and five (5) years of managed care experience in healthcare administration, health insurance, provider contracting, or a related field.
Required Certifications, Registrations, Licenses N/A
Knowledge, Skills and Abilities Knowledge of the health-insurance industry, specifically managed-care contracting operations and negotiation techniques
Knowledge of office equipment (fax/copier)
Proficient computer skills (word processing, spreadsheets, database)
Mathematical skills
Work Shift Day (United States of America)
Location Prisma Health Corporate Office
Facility 7001 Corporate
Department 70019069 Managed Care Contracting
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
Remote work can be considered for this position. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference
Perform contract language review, negotiate and recommend language and reimbursement changes/terms/provisions with payors in accordance with Prisma Health best practices independently as well as in collaboration with Manager, Managed Care Contracting, Financial Project Analysts and Director of Payor Contracting.
Coordinate and assists in managing the processing of all payer contracts and amendments within specified time frames or deadlines in collaboration with internal departments with minimal supervision. Manages and processes payer contracts and amendments including language and reimbursement review. Implements contracts and amendments with team members and internal departments. Tracks and monitors in database, contracts, amendments and renewals.
Provide problem solving support to Prisma Health affiliates and departments. Work closely with payers to ensure that Prisma Health receives all provider manual changes, provider bulletins, benefit plan changes and other payer documents. This position distributes this information throughout Prisma Health in a timely fashion. Conduct pro-active communication, contract compliance, and educational sessions. Develop and maintain effective relationships with payers and internal customers.
Perform detailed analyses of the financial and operational impact of procedural changes implemented by payers in collaboration with financial analysts.
Develops and maintain contracting decision making and tracking tools.
Participate and collaborate on special projects as assigned by Director, of Contracting or Vice President.
Performs other duties as assigned.
Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements Education - Bachelor's degree in Business or a related field.
Experience - Three (3) years of managed-care experience. Experience in a contracting or provider relations role preferred.
In Lieu Of In Lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: high school diploma and five (5) years of managed care experience in healthcare administration, health insurance, provider contracting, or a related field.
Required Certifications, Registrations, Licenses N/A
Knowledge, Skills and Abilities Knowledge of the health-insurance industry, specifically managed-care contracting operations and negotiation techniques
Knowledge of office equipment (fax/copier)
Proficient computer skills (word processing, spreadsheets, database)
Mathematical skills
Work Shift Day (United States of America)
Location Prisma Health Corporate Office
Facility 7001 Corporate
Department 70019069 Managed Care Contracting
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.